Dr. Ghahramani is an academic transplant nephrologist with Master of Sciences in Health Evaluation Sciences. His immediate goal during the proposed grant period is to conduct research to further understand the impact of physician-specific and patient-specific processes that contribute to geographic differences in the choice of kidney transplantation as a treatment option. The aims of the research project are: 1) to compare perceptions of patient suitability for transplant by nephrologists in rural Appalachia with urban areas and to quantify the effect of these differences on referral of patients for transplant; 2) to understand the impact of differences in perceptions of patients in rural Appalachia and urban areas on choosing transplant as a treatment option. These aims will be achieved through analysis of survey data and focus group studies. The candidate's long-term career goal is to lead interdisciplinary patient-oriented research to improve delivery of transplantation care. The proposed career development plan will provide an in-depth research and training experience enabling him to attain this goal. The institution is committed to the candidate's success and has enormous research strengths in the area of the proposed research. The candidate will utilize the resources of the Penn State Population Research Institute and the Survey Research Center, both of which are among the most outstanding research and training programs in the country. His mentors have expertise in survey research, demography, social psychology, healthcare disparities and longitudinal data analysis. He has developed a training program that will supplement his previous coursework through directed study with his mentors, additional formal course work, seminars, and the conduct of the research plan. The candidate has demonstrated commitment to a career in research and professional development. He has completed the NIH-funded K30-MS program and the one-year Junior Faculty Development Program. His clinical expertise relating to nephrology and transplantation, combined with the knowledge and skills he has gained from the K30 program and the formal training in statistics, epidemiology, and survey design have laid the groundwork toward his success as an independent investigator.